What is "misspoke" a euphemism for in this case? She made a mistake when speaking about a policy of the administration. It's not like she made an error in a statement of fact or that she was caught in a lie about something.

One wonders what is going on in the Administration. How much authority does Obama really have over his subordinates. Remember, Obama came into office with no executive experience and only 4 years in the Senate. Working for Obama are people with far more experience in doing things and they all know Obama is a light weight. Even George W. Bush had a lot of authority over others being a 6 year governor of the second largest state - something none of his cabinet members had achieved. If Obama's approval rating falls or Obama loses his magic to pursuade independents, will Obama lose the ability to demand loyalty from his subordinates? Will his Administration run off in a thousand different directions. It's already happening. This is the price we pay for electing a rookie to be President.

Here I thought that the Obama Administration was showing shrewdness, painting opponents into a corner by taking away their two big objections to health care reform. The President--by accepting the regional insurance cooperatives and eliminating end of life counseling costs from the legislation--have pulled a Reagan, compromising and declaring victory.

Did Sibelius speak of out of turn? Or let the White House strategy out of the bag before it was fully prepared to make their compromise public? President Obama clearly intimated at such an accommodation at a town hall meeting over the weekend.

Or was the reaction from liberal Democrats so negative that the White House thought better of compromise? If so, that seems unwise. Where would liberal Democrats go? They wouldn't vote against health care reform even if they didn't like some of any legislation's provisions.

This is a hard one to figure. It seems, for now, that the wheels have popped off. How did the Administration do that when, through Sibelius' statements on Sunday, they had ensured a big win for themselves?

Didn't Kent Conrad announce that the Senate Plan will not have a public Option? The problem for Obama is that there is no desire for a public option in places like North Dakota, South Dakota, Montana, etc... Places that have lots of democratic senators.

This is another example of a candidate who was so good with "staying on message" struggling mightily in the much more complicated mix of an administration. Now to BHO's credit he never said the public option was an absolute but he sure does seem to have a hard time reading his constituents (and who are his constituents anyway, Congress? Democrats??)

Triangleman..."Mispoke" is a way of describing a verbal glitch or freudian slip of the tongue using an opposite wording to that intended by the speaker. This 180 was no such event, and therefore it is a euphemism to communicate that Obama has flat out changed his strategy overnight to a strategy that does not include Obama giving up, and Sebelius goes under the bus for him. Obama obviously wants the meme to become that while he is the courageous President that he was beaten down by a wild and unreasonable anger stoked by evil Republicans and that ridiculous wack job from Wasila.

c3 said... Now to BHO's credit he never said the public option was an absolute

The Ambinder story links to the Obama Speech on the 18th. Unless the definition of "MUST" has changed since then, he said it was an absolute a month ago.

BHO speech on 18 July:

That’s why any plan I sign must include an insurance exchange: a one-stop shopping marketplace where you can compare the benefits, cost and track records of a variety of plans – including a public option to increase competition and keep insurance companies honest – and choose what’s best for your family.

"Now to BHO's credit he never said the public option was an absolute ..."

Um ... except he did say that. Last Saturday, in his weekly radio address he said that any plan he signs must have a public option.

"That's why any plan I sign must include an insurance exchange: a one-stop shopping marketplace where you can compare the benefits, cost and track records of a variety of plans - including a public option to increase competition and keep insurance companies honest - and choose what's best for your family."

I figured it had to be a trial balloon, but it's just not a credible line of argument. With the level of debate and presidential involvement, you can't go back and forth on whether the most important plank of the plan should be in or out.

How can you say we have to nationalize a sixth of the economy one day and change your mind the next? All of your old arguments are as strong as they ever were -- you're just conceding that they aren't convincing enough to act on.

"SEC. 1233. ADVANCE CARE PLANNING CONSULTATION. (a) Medicare. — (1) IN GENERAL. — Section 1861 of the Social Security Act (42 U.S.C. 1395x) is amended — (A) in subsection (s)(2) — (i) by striking 'and' at the end of subparagraph (DD); (ii) by adding 'and' at the end of subparagraph (EE); and (iii) adding at the end the following new subparagraph: '(FF) advance care planning consultation (as defined in subsection (hhh)(1) … "

Can anyone make heads or tails of this paragraph? I sure can't: "A third White House official, via e-mail, said that Sebelius didn't misspeak. 'The media misplayed it,' the third official said." If you don't actually misquote her, how can you "misplay" her comments?

Meanwhile, back at the economic ranch, where you and I work, global markets are selling today on fears of a weak and prolonged recovery.

Consumer confidence is at an all time low, pushed further down by the “crisis using” Reckless-Rham and his Whitehouse Junta (Obama being the mere front man.)

Without increased consumer spending, nothing much good can happen in the economy.

"The consumer has to get on board." said one commenter on Bloomberg Radio.

This just in: coming soon from the Obama administration: blame and demonization of the nervous and hesitant consumer for ruining the recovery.

“If you are out of a job, don’t blame Obama, blame your fellow citizen that refuses to get out and spend.” Said one unnamed WH spokeswoman.

In a town hall meeting organized among supporters today in San Francisco, Obama called for full transparency of household spending decisions.

“The fact that so many people’s entire livelihoods are dependent upon, and are now being crushed by the parsimony or prudence of other households and families, is totally unacceptable in America in the twenty first century, and I promise to change it in my administration!”

“True Americans spend money.” Added House Speaker Nancy Pelosi, who trailed Obama in his tour of the city.

“To tighten your budget, pay off credit card debt, or put a reserve in savings, at the cost of your fellow citizen's jobs, is exactly the kind of un-American hate that we’ve come to expect from the Republican henchmen and their mob followers.”

In Boston today, a consumer was targeted for asking how much something cost at a store, then deciding to not purchase it.

Angry shouts of "Skinflint" and "Tightwad" were hurled at the 34 year old housewife and mother of two, who had to be ushered past unemployed union workers and ACORN memebers, who had surrounded the store demanding more individual spending.

a one-stop shopping marketplace where you can compare the benefits, cost and track records of a variety of plans

I still don't see the value of a public insurance exchange. I can call my independent insurance agent and get quotes for policies from half a dozen companies.

Is it really that hard to use the Yellow Pages?

And since state laws & regulations determine what types of policies are available, does it really make sense to create a national insurance exchange since people in California won't be able to buy a policy offered in Indiana?

Just not overwhelmed by the promise of such a thing. Anyone here have real-world experience with an insurance exchange in your state?

It's hared to understand why the WH is so politically inept, given the Clinton-era experience the top operatives have.

If BHO wanted to strengthen his position on the healthcare bill, he should have announced the he wouldn't sign a final bill unless it includes provisions subjecting all members of Congress and the Administration to the same single-payor plan as all other American citizens.

The average citizen would have said "well...okay."

Now it seems that the President backed down on the major provision of his first legislative battle in the first year of his first term, after just two weeks of town hall meetings, and a one-liner from a former vice presidential candidate.

Can this guy be rolled this easily? Good luck getting anything accomplished for the balance of his term.

And that is a shame because there was an opportunity for a meaningful reform but rather than opting for a measured approach, we instead were presented with 'We won' and 'Just STFU and let us fix it'.

I said it before, human nature doesn't go for overwhelming change. Obama's 'Change' slogan really meant 'I won't be like Bush' and I think thats what most were looking at when His Imminence was running. When it comes to actually 'changing' things, you know, things that will affect you people tend to be a bit more resistant.

The Obama Administration is floundering simply because they picked the wrong MAJOR issue at the wrong MAJOR time.

You want to see a happy American, give them a J...O...B! See, if President Obama made employment his #1 issue, he would be enjoying a "glow" right now while raising his employment numbers to great heights. A big infrastructure project that uses the best of private companies and some public administration (making sure money gets to the private companies to assist in the big infrastructure project) would have been freakin' brilliant. Give me a unemployed Republican/conservative that gets a job from "Obamastructure" (wow what a name), Obama would have earned a more sympathetic ear towards some reasonable health care reform down the road.

But you can't pass sweeping health care reform in a bad economic environment. Main street will balk because they see dollars flying out their pockets.

By the way, have you realized just how extensive the political corruption would be be under a government controlled single payor system?

Suppose a family member has been denied a potentially life-saving bone marrow transplant because if the age of the victim and the cost of the procedure. First that that'll happen is that calls will be made to the victim's Congressman, seeking intervention, and reminding the Congressman that the victim and his/her relatives have been staunch contributors, and will up their contributions for ht next election.

One suggestion is that the Obama Administration maybe circulate a memo or have a conference call or a arrange a meeting to lay out the actual positions on the various issues, before sending representatives out to speak on its behalf.

It could even be on a single piece of paper, called, like talking points, or something like that.

Well, well, well ... seems Marc Ambinder needs to find a new source. His seems to have misspoken.

Here's Barack Obama himself clarifiying his intentions:

"The public option - whether we have it or we don't have it - is not the entirety of health reform. This is just one sliver of it."

So, the President himself is suggesting that a public option isn't a deal-breaker.

Why quote some unnamed "administration source" (not even a Senior Administration source) when you can quote the actual President suggesting that the public option isn't critical to his vision of health reform.

(See MSNBC's website for the link to the video of the President's comments).

T-Steel : You want to see a happy American, give them a J...O...B! See, if President Obama made employment his #1 issue, he would be enjoying a "glow" right now while raising his employment numbers to great heights.

Obama did do that, it's exactly what his stimulus bill is all about. Since he "solved" that problem he's moved on to health care. I'm expecting similar results.

if President Obama made employment his #1 issue, he would be enjoying a "glow" right now

True, but that doesn't fit with his ideological views of redistributing wealth.

In the system that Obama wants to institute the favored classes are not the people who make permanent jobs. Instead he wants to bring the economy down in order to bring the 'special' people up.

He is still looking at the entire economy from the perspective of a Community Organizer who attempts to take money from "the man" who is oppressing the 'poor' and downtrodden pipples in the inner cities. That works until you ARE "the man". Now he wants to take the money from the American People who have no desire to fund his Community Organizing pipe dreams.

Real and permanent jobs are not created by the government. Businesses do not expand under onerous government regulations and burdensome taxes.

Obama is a JOB KILLER and he doesn't give a rip. He doesn't understand economics, business or much of anything else and is a blind ideologue who wants to 'spread the wealth'.

When I see comments, as I have been lately and more often, that say something to the extent of, "why does this senator from this crappy little state that represents some a tiny percentage of population have so much power?"

I instantly tune out pretty much whatever else that person has to say. The system was DESIGNED so each state gets an arbitrary 2 senators. How much more plain an answer does one need? Fine, add the layer about who's got what seniority and who then gets committee chairmanships, but you expose yourself to arguing that a 30-year veteran senator from Rhode Island shouldn't be able to chair a committee.

I see a lot of these "why does this senator from the small state" posts from primarily progressive/liberal/left/insane bloggers bitching about where the health debate currently sits.

Angry shouts of "Skinflint" and "Tightwad" were hurled at the 34 year old housewife and mother of two, who had to be ushered past unemployed union workers and ACORN memebers, who had surrounded the store demanding more individual spending.

Too funny! I thought about purchasing a DSLR, but figured we might not have seen the end of furloughs here. Guantanamo, here I come!

Dogwood said...And since state laws & regulations determine what types of policies are available, does it really make sense to create a national insurance exchange since people in California won't be able to buy a policy offered in Indiana?

Alternately, Obama could pass a health insurance reform act that did nothing more than allow private insurers to sell policies across state lines. That would bring down costs and lower prices.

PS: there are already many health insurance firms that are not-for-profit. Kaiser Permanente and many of the BCBS state firms for example

Simple inexperience and a Marxist ideology crimped mindset of Barry Obama is a mild/moderate reasoning that tries to account for his destructive acts towards the American economy. He would do better if only he knew what he was doing. IMO those are not the reasons Barry refuses to rescue an American economy that supports an American military power that has maintained the Pax Americana over the last 50 years. The world has a taste for wealth taken by conquest, like the Somalie pirates do, and Barry wants to see more chaos until only a strong moslem man can handle it.

Alternately, Obama could pass a health insurance reform act that did nothing more than allow private insurers to sell policies across state lines. That would bring down costs and lower prices.

Yes and no.

Insurance is all about risk pools and sharing the risk across a group of people. In some areas the risk is a lot less and in other geographic areas the risk is higher. This is why people who live in a high crime area pay more for car insurance.

A similar thing can be said for health insurance. The amount of claims paid and therefore the risk that the insurance company is taking are much less in States like Utah compared to other areas where people are not as healthy or have a higher proportion of poor. The premiums on a risk pool of Mormons or Amish is certainly going to be much less than a group that isn't healthy.

By allowing anyone to buy insurance in Utah, the make up of the risk pool will be adversely changed and the company will have to increase premiums.

It is sort of like trying to bail out the bathtub by moving the water from one end to the other. Won't work.

NOW....if the insurance companies were able to sort the nationwide risk pools by actual risk then the healthy people no matter where they live would get good rates. And the unhealthy would get higher rates.

The issue is that Obama and many others don't understand the mechanics of insurance and want to make it all "FAIR". It no longer becomes insurance if everyone pays the same amount.

Alternately, Obama could pass a health insurance reform act that did nothing more than allow private insurers to sell policies across state lines. That would bring down costs and lower prices.

I was thinking about that today in the context of the Mackey editorial. It would make an awful lot of sense. It's a perfect scenario for competitive federalism, where states would compete to have attractive regulations. You would have a really good chance of cutting costs and decreasing the number of uninsured at the same time. Plus, a lot of good ideas like high deductible catastrophic insurance would get a chance to thrive. Plus, there's enough overlap with the idea of an insurance clearing house that Obama could save face.

It would really be too bad if we went to some centrally planned behemoth just because some people don't want to waste a crisis.

I think that Obama's dream of taking over big chunks of the economy have been slowed down, but it is just a matter of time until he thinks of some other area to sieze. True Marxists, like rust, never sleep.

... said that President Obama believed that a public option was the best way to reduce costs and promote competition among insurance companies.

I'd like to know what makes the Obama believe that. I believe he doesn't believe that. I believe he's lying when he says he believes in competition. Why do I believe this? Because in a moment of rare candor, which is bound to happen occasionally when you talk constantly, or when you're drunk, possibly drunk on one's own words as this man is, he said so. He intends to initiate a one-payer system. That's the way of saying he believes in socialized health-care without using the word socialism.

When Obama tells you if you like your coverage you can keep it, what he's leaving out is your coverage will not be there for you to keep, plus you'll be paying double just as those who find public education insufficient, and if you believe public education is efficient, well, I have nothing but derisive laughter for that.

I was thinking about that today in the context of the Mackey editorial. It would make an awful lot of sense. It's a perfect scenario for competitive federalism, where states would compete to have attractive regulations.

That is what's happening with the individual state's tax codes. The states that have the lowest state income tax rates are the same states that have a stronger economy and attract new businesses.

I hear this a lot and honestly don't see how buying a policy from an insurer licensed in Illinois is bringing down costs? Most insurers are licensed in multiple states anyway.

They are licensed to sell policies in multiple states, but each state has different mandates regarding what is or is not covered. Those mandates impact the cost of those policies.

Allowing companies to offer a standard, nationwide policy would significantly reduce legal & administrative costs while allowing the insurance company to spread the risk over a greater number of people.

Also, commenters in other threads have stated that some states don't allow catastrophic-only insurance policies, or they severely restrict such policies, so removing those regulatory hurdles could make health insurance much more affordable for those who can't or won't pay $14,000 per year for comprehensive health care policies.

Finally, not all insurance companies do business in every state due to those state regulatory regimes. Allowing nationwide policies would encourage those companies to move into new markets, thus fostering competition.

Regulations should protect consumers from fraud, but over the years the 50 states have created regulatory environments that limit choice and competition, thus increasing costs.

If Obama is truly interested in reducing costs, then this is one area that needs some attention. It won't fix the problem all by itself, but it will help.

Obama is so WEAK KNEED when it comes to apologizing to our enemies overseas. And so RUTHLESS when it comes to taking over our economy, killing grandma, and putting us in camps. How could we be so this unlucky????? Regret that vote yet Ann?????

"When Obama tells you if you like your coverage you can keep it, what he's leaving out is your coverage will not be there for you to keep, plus you'll be paying double just as those who find public education insufficient, and if you believe public education is efficient, well, I have nothing but derisive laughter for that."

Education is an interesting analogy. Over the last 35+ years, the federal government has become increasingly involved in public education.

On average, has public education improved, in terms of costs or outcomes, during that time?

"On average, has public education improved, in terms of costs or outcomes, during that time?"

Quite the opposite, in fact, and I don't know why this isn't used more by opponents of Obama's health care reform. We used to have one of the best public school systems in the world (granted part of that was the fact that part of the world was partly smashed into component parts, but that's another thread). The FEDEREAL government getting involved screwed the pooch good.

I see education as a defense issue that, should it be housed under a federal entity, should fall under the DoD. That's tough to admit as a libertarian, but I can only be a libertarian as long as there's a country to be one in.

Ideally, it would work like corporate law, where some ridiculous fraction of US corporations are licensed in Delaware because that's the state with the most favorable regulations.

Suppose you live in a high cost state, with mandatory issuance and coverage rules. You could then buy insurance from some state that didn't have those rules.

Yes but that is simply one aspect of the overall costs of coverage. DBQ correctly pointed out insurance is pooling risk and considering so many insurers are already operating in multiple states, I’m not certain how me belonging to Anthem’s pool of Illinois insureds is going to save me money.

I keep pounding this theme home but this is insurance but we want it to act like a pre-paid health plan. If people expect the insurer to cover everything except a $20 co-pay then yes, the coverage is going to be expensive. I’m sorry but if you’re chronically ill the insurer is faced with a certain benefit payment rather than a potential risk. For example, if I as an underwriter know you are a diabetic then I know that at a minimum you will cost $X per month in diabetic supplies. I also then know from underwriting experience that you will most likely cost $X in additional medical treatment just based upon that condition. It’s the equivalent of insuring someone’s roof when the underwriter is looking at a picture of missing shingles, holes and finding out the roof is 20 years old. If the state makes me issue coverage for it then fine but it will cost a crap ton because I know as an underwriter we’ll be paying a claim on it the next time it rains.

This is why people who live in a high crime area pay more for car insurance. .

I'd take it even farther. Like Rush Limbaugh so brilliantly said; [T]here's no federal dog healthcare plan out there, and it's working just fine"

You pay for what you can afford. It works!

Except, garage, that I think most rational people will admit that there are cost ceilings with pets, regardless of our feelings for them. Are you prepared to suggest that there are cost ceilings on human beings?

"On average, has public education improved, in terms of costs or outcomes, during that time?"

Honestly, I would say yes. It has improved. The difference is expectations have grown much more than the improvements. We expect every child to be an intellectual and go on to graduate from college. 30 years ago, this wasn't the expectation. There's also an increasing interest in not leaving any child behind. More than a capitalized policy this is a real, driving interest that makes the lowest performing students the marker of a educational effectiveness. Thirty years ago lots of people were left behind in education, and then they got the sorts of jobs that didn't require a lot of learning. Blue-collar is now a bit of an insult in many circles.

Can you imagine saying the goal of education is to help all kids be able to find good blue-collar jobs?

The federal involvement has not been entirely great, to be sure, but it has allowed for increasing awareness of the disparities in educational opportunities and started the process of finding ways past this.

Certainly, only local involvement would be ideal, but in far too many cases locales differ immensely in how practically ideal this is.

WV: gerin. It's those gerin's who vote down all the local school reforms because they're old, selfish jerks.

Except, garage, that I think most rational people will admit that there are cost ceilings with pets, regardless of our feelings for them. Are you prepared to suggest that there are cost ceilings on human beings?

Considering that there is a finite amount of money that even we can print or borrow, I'd say yes, there probably is. We already spend the better part of $400 billion a year on 42 million Medicare beneficiaries. We could eliminate the entire defense budget and cover another 42 million based upon those same costs. The real question both sides need to start asking is how much of our earnings are we going to hand over to Uncle Sam to pay for it?

Actually we don't have those things garage, that was my point. How much of our incomes are we willing to part with to pay for you having unlimited health care? I mean we have 300 million people in the US of KKKA so how much do we budget for it?

One can go online and do a comparison of insurance policies across companies.

A question I have, (but I am pretty sure I don't want the Feds to provide the solution -- ):

Looking for a health insurance policy for my college student daughter --

If her permanent ("legal," I guess) residence is in NC and she is in school in TN the company in question has a nice little policy for her at a pretty good rate.

The exact same policy for the same person from the same company if she is a legal resident of TN and going to college in TN costs *more* than twice as much.

Why? Is it state insurance oversight? TN has TennCare -- which I am not well informed about. Is that part of the problem?

Just wondering. And there is "affordable" insurance out there for college students and young people. I cannot imagine a 24 yo utilizing an HSA. And lots of time thepolicies exclude scuba diving, getting on, off, or riding ATVs, bungee jumping, etc ...

So not to misspeak the thread here, is there maybe an actuarial explanation for this difference?

WV gensorA device which senses you generation (X, Y, Z, or Over the Hill)

Unless you have the earlier version of Bernie Madoff sending you back your own money plus a chunk of someone else's money, then money is not easy to come by. The ease with which the same type of Ponzi scheme operation could roll out the transfer payments dough since 1965 is indeed over unless we find Great Multitudes of employed young people to restart it. Trouble is we aborted so many that we are frantically having to import them from Hispanic/Catholic countries. But the capital to employ them has since 1990 relocated to cheap wage/no benefit asian countries whom we have until now conned into sending back their savings into our new Mortgage Backed Securities Ponzi Scheme and bubble up to 2006. Now we are desperately avoiding seeing that truth, while the realists among us are secretly cashing out ASAP. IMO we desperately need new leadership that will tell us the truth.

Just wondering. And there is "affordable" insurance out there for college students and young people. I cannot imagine a 24 yo utilizing an HSA.

If you are relatively healthy, you can find affordable insurance pretty much from any company. The rub is whether the affordability means less money you can spend on Lalapalooza tickets or that spunky new Iphone. I’ve heard stories about ‘healthy people’ paying $2000K per month on insurance and that is either some platinum plan or bullshit and I lean toward the latter. I’ve priced individual coverage on myself and at 42 years old and taking one prescription med, I haven’t found one that would be put me over $200/month and that’s a $1000 deductible with a $30 copay and Rx benefits.

So not to misspeak the thread here, is there maybe an actuarial explanation for this difference?

That is interesting. It may have something to do with her being a college student. Also is it a renewable policy or short term? While you are right that a college students doesn’t need an HSA, they probably don’t need a comprehensive coverage policy either.

Michael: I have friends with college-age kids who (the friends and the kids) don't like the health service option because it's clinic based. They don't get to have a private doctor! They won't be able to pick their doctor, or even see the same on all the time! They have to wait sometimes (in the clinic, I mean--not weeks for an appointment)! Their cold might not take precedence over someone else's scratched eye! Etc.

There are various reasons why health care was so much cheaper back in my own college and early adulthood days, and one of them was that expectations were, for the most part, quite different ... .

Recently, I was visiting with an old college friend, whose own daughter is now in college. The daughter was complaining about the health service because the doctors there weren't very helpful in writing medical excuses for missed work (school work and "work" work). To my old friend's great good credit, she "poor-baby" laughed every bit as much as I did.

Her previous school *required* health insurance proof. If she wasn't covered by our policy (she's not, Dad is retired and one of those awful Medicare covered people) we had the option of 0covering her through a policy they had negotiated, for $360 for the year. I am assuming it was partially subsidized by the school. The school, a small private one, also had a free clinic with access to physician and FNP through nurse triage.

She has transferred to a different small private school in a different state. This one also has a clinc with physican and nurses. They do not have a health insurance plan through the school which one can pick up. They do not require students to have health insurance, but they recommend it.

So in my scouting around I have found several options. She is quite healthy, has no chronic problems and no hx of injuries or hospitalizations. For college students they do not ask any of the usual questions, though one policy wanted to know if she was a smoker.

My question was an explanation for her legal state of residence altering the cost by >100% in the same policy from the same company, when in fact most of her time she is going to be in TN anyway.

The problem with the high deductibles is no one these days wants to pay for a $75 visit with a guy who can tell you if you have melanoma or a wart. Everyone wants $20 visits.

And new wage earners, of course are freaked out by the $2500 - $5000 deductibles. They don't have that much money. Course short of a couple MRIs, they won't need that much money.

But I would guess that very few young people get there.

Many of the student policies, as I mentioned, exclude many of the things which put students into operating rooms.

Perhaps students shouldn't do those things if they're not willing to pay a high price for special coverage. Who NEEDS to sky-dive or Bungee-jump, after all, or even use an ATV for strictly leisure purposes? The word "choices" doesn't just apply to those you *want* to make, after all: it also applies to those you don't.

"It's hared to understand why the WH is so politically inept, given the Clinton-era experience the top operatives have"

Not hard at all. Just look at who is SoS and who they might get to replace Zero. If they can make his look even worse than he already is, and that is hard to do, then just maybe they can win for the Thunder Thighs.

My question was an explanation for her legal state of residence altering the cost by >100% in the same policy from the same company, when in fact most of her time she is going to be in TN anyway.

JAL I have no clue.

The problem with the high deductibles is no one these days wants to pay for a $75 visit with a guy who can tell you if you have melanoma or a wart. Everyone wants $20 visits.

Actually this is the problem with health insurance in general. Again, key word being "insurance" which is supposed to protect you against catastrophic losses not every trip to the doc's office because you have a boo boo.

Everyone want's to pay only $20 for thier medical care but are outraged that the insurance costs so much.

I know the posts are moving on (every day is stunning with BHO, so much to do, so little time) I am curious about the history of patients (oh, wait they are "health consumers") not paying for a visit to the doctor, or paying a small percentage.

Did that develop as part of the insurance business becoming "more competitive?"

I am curious about the history of patients (oh, wait they are "health consumers") not paying for a visit to the doctor, or paying a small percentage.

Did that develop as part of the insurance business becoming "more competitive?"

Basically yes. There was a time that most health insurance plans were basically cat coverage plans in which you handled the routine care and the insurance kicked in when you were faced with acute care treatment due to illness or accident.

As an example, back in the early 1970s as a kid, I had pretty bad allergies that required allergy shots every two weeks. Mom wrote a check for every visit. As time progressed insurers started offering more benefits and more comprehensive coverage in order to lure more customers. Couple that with more advanced medical technology and here we are. So in effect, the insurance companies in large part drove the culture to the point where we expect full coverage for everything with little or no out of pocket costs to our selves. At one time, health insurance was just that, it insured you against catastrophic loss, not every trip to the doctor's office.

Hoosierdaddy, I remember the days of $33 office visits, $19 if you only wanted to see the NP and most of the time the NP could do whatever you needed; and it was up to you to file your insurance if you wanted that to go to your deductible. I usually didn't bother in the years when I didn't expect to meet the deductible, which was most of them.

Dental visits were much cheaper, too, before dental insurance came along.

When you have to pay the extra clerical help to file and keep on top of insurance claims, and wait 30 days to 6 months for your money, you have to raise your prices.